Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries.Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution.Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the...

BackgroundLow birth weight (LBW) is closely associated with foetal and neonatal mortality and morbidity, inhibite growth and cognitive development and resulted chronic diseases later in life. Many factors affect foetal growth and thus, the birth weight. These factors operate to various extents in different environments and cultures. The prevalence of low birth weight in the study area is the highest in the country. To the investigator’s knowledge in Bale Zone, no study has yet been done to elucidate the risk factors for low birth weight using case control study design. This study was aimed to identify the risk factors of low birth weight in Bale zone hospitals.MethodsA case–control study design was applied from April 1st to August 30th, 2013. A total of 387 mothers (136 cases and 272 controls) were interviewed using structured and pretested questionnaire by trained data collectors working in delivery ward. For each case, two consecutive controls were included in the study. All cases and controls were mothers with singleton birth, full term babies, no diabetes mellitus and no hypertensive. The data were entered and analyzed using SPSS version 16.0 statistical package. The association between the independent variables and dependent variable (birth weight) was evaluated through bivariate and multiple logistic regression analyses.ResultMaternal age at delivery <20 years (adjusted odds ratio (AOR) = 3; 95 % confidence interval (CI) = 1.65–5.73), monthly income <26 United States Dollarr (USD) (AOR = 3.8; 95 % CI = 1.54–9.41), lack of formal education (AOR = 6; 95 % CI = 1.34–26.90), being merchant (AOR = 0.1; 95 %CI = 0.02–0.52) and residing in rural area (AOR = 2.1; 95 % CI = 1.04–4.33) were socio-economic variables associated with low birth weight. Maternal risk factors like occurrence of health problems during pregnancy (AOR = 6.3; 95 % CI = 2.75–14.48), maternal body mass index <18 kg/m2 (AOR = 6.7; 95 % CI = 1.21–37.14), maternal height <1.5m (AOR = 3.7; 95 % CI = 1.22–11.28), inter-pregnancy interval <2 years (AOR = 3; 95 % CI = 1.58–6.31], absence of antenatal care (OR = 2.9; 95 % CI = 1.23–6.94) and history of khat chewing (AOR = 6.4; 95 % CI = 2.42–17.10) and environmental factors such as using firewood for cooking (AOR = 2.7; 95 % CI = 1.01–7.17), using kerosene for cooking (AOR = 8.9; 95 % CI = 2.54–31.11), wash hands with water only (AOR = 2.2; 95 % CI = 1.30–3.90) and not having separate kitchen room (AOR = 2.6; 95 % CI = 1.36–4.85) were associated with low birth weight.ConclusionWomen who residing in rural area, faced health problems during current pregnancy, had no antenatal care follow-up and use firewood as energy source were found to be more likely to give low birth weight babies. Improving a mother’s awareness and practice for a healthy pregnancy needs to be emphasized to reverse LBW related problems.

BackgroundWomen's autonomy in health-care decision is a prerequisite for improvements in maternal and child health. Little is known about women’s autonomy and its influencing factors on maternal and child health care in Ethiopia. Therefore, this study was conducted to assess women’s autonomy and identify associated factors in Southeast Ethiopia.MethodA community based cross-sectional study was conducted from March 19th until March 28th, 2011. A total of 706 women were selected using stratified sampling technique from rural and urban kebeles. The quantitative data were collected by interviewer administered questionnaire and analyzed using SPSS for window version 16.0. Descriptive statistics, bivariate and multiple logistic regression analyses were carried out to identify factors associated with women’s autonomy for health care utilization.ResultOut of 706 women less than half (41.4%) had higher autonomy regarding their own and their children’s health. In the multiple logistic regression model monthly household income >1000 ETB [adjusted odds ratio(AOR):3.32(95% C.I: 1.62-6.78)], having employed husband [AOR: 3.75 (95% C.I:1.24-11.32)], being in a nuclear family structure [AOR: 0.53(95% C.I: 0.33-0.87)], being in monogamous marriage [AOR: 3.18(95% C.I: 1.35-7.50)], being knowledgeable and having favorable attitude toward maternal and child health care services were independently associated with an increased odds of women’s autonomy.ConclusionSocio-demographic and maternal factors (knowledge and attitude) were found to influence women’s autonomy. Interventions targeting women’s autonomy with regards to maternal and child health care should focus on addressing increasing awareness and priority should be given to women with a lower socioeconomic status.

BackgroundAcademic achievement of school age children can be affected by several factors such as nutritional status, demographics, and socioeconomic factors. Though evidence about the magnitude of malnutrition is well established in Ethiopia, there is a paucity of evidence about the association of nutritional status with academic performance among the nation’s school age children. Hence, this study aimed to determine how nutritional status and cognitive function are associated with academic performance of school children in Goba town, South East Ethiopia.MethodsAn institution based cross-sectional study was conducted among 131 school age students from primary schools in Goba town enrolled during the 2013/2014 academic year. The nutritional status of students was assessed by anthropometric measurement, while the cognitive assessment was measured by the Kaufman Assessment Battery for Children (KABC-II) and Ravens colored progressive matrices (Raven’s CPM) tests. The academic performance of the school children was measured by collecting the preceding semester academic result from the school record. Descriptive statistics, bivariate and multivariable linear regression were used in the statistical analysis.ResultsThis study found a statistically significant positive association between all cognitive test scores and average academic performance except for number recall (p = 0.12) and hand movements (p = 0.08). The correlation between all cognitive test scores and mathematics score was found positive and statistically significant (p < 0.05). In the multivariable linear regression model, better wealth index was significantly associated with higher mathematics score (ß = 0.63; 95 % CI: 0.12–0.74). Similarly a unit change in height for age z score resulted in 2.11 unit change in mathematics score (ß = 2.11; 95 % CI: 0.002–4.21). A single unit change of wealth index resulted 0.53 unit changes in average score of all academic subjects among school age children (ß = 0.53; 95 % CI: 0.11–0.95). A single unit change of age resulted 3.23 unit change in average score of all academic subjects among school age children (ß = 3.23; 95 % CI: 1.20–5.27).ConclusionNutritional status (height for age Z score) and wealth could be modifiable factors to improve academic performance of school age children. Moreover, interventions to improve nutrition for mothers and children may be an important contributor to academic success and national economic growth in Ethiopia. Further study with strong design and large sample size is needed.

Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea.Methods We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates.Findings The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54•0% (95% uncertainty interval [UI] 38•1-65•8), 17•4% (7•7-28•4), and 59•5% (34•2-86•9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage.Interpretation By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health.Funding Bill & Melinda Gates Foundation.